VSJF Business Management Coaching Initial Contact Form

Let Us Help You and Your Business

If you are an entrepreneur that owns a business with $250,000+ gross revenue and in operation for 3+ years, and you are interested in working with the Vermont Sustainable Jobs Fund’s Business Coaching program, please fill out the questionnaire below. The information being collected will be used as your first point of contact with us so that we may know a little about you and your business before an initial call or meeting. It will help us better serve your needs. Please note that information provided in this form will not be shared with anyone outside our organization.

Please note that at this time we do not have capacity to work with start-up businesses and businesses with less than $250,000 of gross income. Through the Small Business Administration’s Community Navigator Pilot Program, which uses a “hub and spoke” model, with VtSBDC as the hub, and nine partner organizations as spokes, there may be another organization that can assist you in your journey: https://www.vtsbdc.org/community-navigator-pilot-program-cnpp/.

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* 1. Contact Information

Contact Person Name

Title/Position

Email Address

Phone Number

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* 2. Business Information

Business Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

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* 3. Website Address

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* 4. Type of Business (check all that apply):

Agriculture

Food Products

Forest Products

Renewable Energy / Efficiency

Environmental Technology

Waste Management

Construction

Retail Trade

Manufacturing

Wholesale Trade

Other (please specify)

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* 5. In a couple of sentences, tell me about your business:

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* 6. We Need Assistance With (check all that apply):

Strategic Planning

Production Management: utilization, scale, # of products, mass customization

Inventory Management

Market Segmentation Analysis

Sales Strategy Development

Communications with Customer

Pricing / Cost of Production / Margin Review

Cash Flow Planning

Human Resources (e.g., recruitment, retention, policy development)

Expansion Planning (e.g., building, equipment, new product lines)

Sounding Board for Major Decisions

Exit / Transition Strategy

Product Development / Brand Positioning (packaging, merchandising, point of sale, etc.)

Brand Marketing, Promotion, Social Media

Other (please specify)

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* 7. Which type of coaching service are you most interested in (check all that apply):

Deep Dive Coaching: Work with a team of coaches over 12-18 months

Focused Coaching: Work with one coach over 9-12 months

Intensive Coaching: Work with one coach over 3-4 months to solve a short-term problem or time-sensitive situation

Small Peer Group: Be a part of a monthly learning session, plus receive 2 hours of 1:1 coaching monthly

Not Sure

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* 8. Business Location:

Urban

Suburban

Rural

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* 9. Has Your Business Been in Operation for 3+ Years?

Yes

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* 10. Year Business Started:

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* 11. Legal Entity:

Sole Proprietor

C-Corp

S-Corp

LLC or L3C

Partnership

Cooperative

Non-Profit

Other (please specify)

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* 12. Total Number of Employees:

# Full-Time

# Part-Time

# Seasonal

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* 13. Gross revenue for most recent business year:

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* 14. How did you hear about our program? (check all that apply)

Referred by Someone

Website

Internet Search

News Article

Social Media (Facebook, LinkedIn, other)

Other (please specify)

Business Owner Demographics - We are asking about your ownership demographics to help better serve you and access various funding sources. These questions are optional.

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* 15. Gender Identity (optional):

Female

Male

Non-binary

Prefer Not to Say

Prefer to Self-Describe

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* 16. Race and Ethnicity (optional):

American Indian or Alaska Native

Black or African American

Native Hawaiian or other Pacific Islander

White

Latino or Hispanic

Prefer Not to Say

Prefer to Self-Describe

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* 17. Identity (optional):

Intersex

Transgender

Bisexual

Gay/Lesbian

Heterosexual

Prefer Not to Say

Prefer to Self-Describe

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* 18. Do you consider yourself a person with a disability (optional):

Yes

Prefer Not to Say

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* 19. Military Service (optional):

Veteran

Active Duty

Service-Disabled Veteran

Spouse of Military Member

No Military Service

Prefer Not to Say

VSJF Business Management Coaching Initial Contact Form

Let Us Help You and Your Business

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* 1. Contact Information

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* 2. Business Information

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* 3. Website Address

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* 4. Type of Business (check all that apply):

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* 5. In a couple of sentences, tell me about your business:

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* 6. We Need Assistance With (check all that apply):

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* 7. Which type of coaching service are you most interested in (check all that apply):

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* 8. Business Location:

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* 9. Has Your Business Been in Operation for 3+ Years?

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* 10. Year Business Started:

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* 11. Legal Entity:

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* 12. Total Number of Employees:

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* 13. Gross revenue for most recent business year:

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* 14. How did you hear about our program? (check all that apply)

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* 15. Gender Identity (optional):

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* 16. Race and Ethnicity (optional):

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* 17. Identity (optional):

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* 18. Do you consider yourself a person with a disability (optional):

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* 19. Military Service (optional):

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* 20. In what language do you conduct your business?

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* 21. In what language are you requesting assistance in?

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* 22. Is there anything additional that you'd like us to know about you or your business?